Dear Prudence,
My wife is nine months pregnant and we are planning a home birth. Our team of two midwives came to our house to do a home visit last week, and shamed us for about 30 minutes when we let them know we would be vaccinating our baby. One of them (whom we’ve only met twice before) was adamant that we weren’t considering the safety and health of our child. I almost kicked her out of our house, I was so angry. Now I’m nervous my wife will be on edge about their judgment when the whole point of a home birth for us was so she’d feel more relaxed. I know it’s very late in the game, but should we be looking for a new birth team?

—Womb Service

Dear Womb,
I had a variation of your experience when I was pregnant (although not as far along). A test showed that I might have a serious autoimmune disease. Fortunately, it turned out to be a false positive. When I went in to talk about the results, I was seen by my obstetrician’s partner, whom I’d never met before. I expressed my relief, and she said that the false positive actually meant I was at higher risk for the disease. When I asked her what I should do about that, she said, “Look, we’re all going to die of something.” True enough! Because it was possible that when I went into labor she might be on call, I immediately found another obstetrician and switched practices. You don’t have a long bond with these people, but you do have a short timeline. You’re choosing a home birth because a comfortable environment is a high priority. I would not be comfortable if I knew that when I was at my most vulnerable, I would be subjected to an insane lecture whose premise is false and dangerous. I think you should fire this pair and find another team. If it turns out all the midwives in your community believe this anti-vaccine garbage, then see if there’s a hospital with a birthing suite that strives to provide a more “homey” environment. You don’t want to have one of the happiest times in your lives ruined by misinformed bullies.

—Prudie

Dear Prudence,
I recently found out I am pregnant. Though I am excited about the news and in a good position to have a child (stable relationship with my husband, financially prepared, 29 years old, family support), I feel a loss. It relates to the fact that I always felt that my career was the way in which I would bring more light into this world—what G-d put me on earth to do. The patient population I serve has overwhelming needs, and as I prepare for a maternity leave and a scaling back of duties, I feel guilty for abandoning them. Many don’t have parents who are willing or able to take care of them. I know it’s not fair to my future child to feel that these people’s needs are greater than his or hers, but I can’t help shake the feeling. I feel like the notion I grew up with of a woman being able to do it all was naive. It seems like it was a lie, and that we as women are just biologically disadvantaged when it comes to careers, etc. When I bring this issue up with friends they seem to look at me like I’m a bit of a monster to think that anything should be put ahead of my (future) children. I don’t need any more judgment, just some advice—woman to woman.

—Guilty Mom-to-Be

Dear Guilty,
Right now your baby is a fuzzy image on a sonogram, while your patients are physically here and needy. You see every day what it means for children to lack the kind of devoted parents that everyone deserves. So I’m confident you will be that kind of parent to your own child. As important and meaningful as your work is, you alone cannot fulfill all the wants of your high-risk community. You must be able to step away and have a separate life, or you risk becoming less effective by burning out. You talk about the biological disadvantages of being a female, but I see it differently. You must admit it’s pretty amazing to be able to gestate another human being. (Or, alternately, as Mel Brooks observed, “Wouldn’t you be nauseous if somebody was running around inside of you?”) Another thing about biology is that when they hand you this brand-new little person, you’ll be overwhelmed with the kind of feelings you’re now dubious about. You will also find that there’s no reason your career can’t continue to be deeply gratifying and even consuming; the time limits imposed by having your own family will make you more focused when you are at work. Some of my most prolific colleagues are women with three children. I don’t get how they do it, but looking at them convinces me, despite the small sample size, that the reason I’m not more productive is that I had an only, instead of triplets. I should also mention that there’s growing evidence that “post-partum depression” is a misnomer and there is a range of pregnancy-related psychological disorders that can begin before the baby is born. If you feel your thoughts are running away with you, tell your obstetrician and seek help. But I think you’re just a deeply caring person who wonders if your own well of love and compassion will be deep enough for everyone in your life. I’m sure you’ll find it’s a renewable resource.

—Prudie

Dear Prudence,
I’m 56 years old and my husband of 37 years died three months ago. He was retired and was the sole caretaker for his 83-year-old mom who lives with us in the duplex we set up for her. My husband’s sister died suddenly last week at age 57. She had been planning to move in and take care of her mother. I am left with my mother-in-law, who has now lost all four of her children. My mother-in-law is incapable of being alone, now more than ever. There is no physical reason for her lack of independence; it’s more mental, which I can understand given what she’s been through. But I’m at work all day, and can’t take care of her. My stepdaughter lives close by with her three children and a husband who is dying of cancer. He was given two weeks to live last February, and is defying the odds, but it’s only a matter of time. She feels obligated to take care of her grandma and probably worries about what I’m going to do. I haven’t made any decisions. I wish my mother-in-law would see how hard babysitting her is. If ever there was a candidate for assisted living it’s her, but I don’t think she’s come around to thinking that. I have compassion for her but it hurts so much to be around her and I’m grieving too. I still feel somewhat young and that there is happiness and a life to be had ahead of me, but there is no way to move on right now. Do I just wait this out and stay put? I’m afraid that she could live another 10 years like this. And I feel awful for even thinking that.

—Guilty and Grieving

Dear Grieving,
Please stop feeling guilty. Just reading your letter is crushing, so I can’t imagine what it must be like to deal with this series of tragedies. First of all, you and everyone you care about are in terrible pain. Your stepdaughter cannot let herself be torn apart over her obligations to her grandmother. It’s lovely she cares, but she has a dying husband and three children, and that’s where her focus has to be. You, too, need to be able to work through your own grief and loss without having to carry those of your mother-in-law as well. Right now, you need to engage some social services for her. She could use a therapist who specializes in geriatric patients, for starters. Perhaps there’s adult day care in your community. There are also organizations that provide meals and visitors for the elderly. She’s not incapacitated, so as tough as it may be emotionally, she’s not in physical danger if she has to spend part of the day alone. But given the situation you lay out, it’s true that assisted living is an excellent alternative. Lots of people are consumed with guilt about the thought of putting a loved one there. But a well-run place can be a tonic for an older person who otherwise would be isolated. Being distracted by activities and sharing meals—and withdrawing to her own room when needed—sounds much better than feeling frantic and lonely in her duplex. You are overwhelmed, so put off thinking about changing anyone’s living situation until after the first of the year. But eventually taking steps to allow you to move on with your life while making sure your mother-in-law is well cared for are not mutually exclusive.

—Prudie

Dear Prudie,
I’m male, age 56. I work in an office with four women, average age 45. One of the women and her husband just installed an outdoor hot tub on their patio and invited all of us (and spouses) over for a Thanksgiving weekend “tub party.” She told us they didn’t wear bathing suits, so we shouldn’t either and should just bring a towel. All of our co-workers said they’d be there. My wife is hesitant, as I am. What do you think?

—Hot Tub or Not Tub?

Dear Hot,
This is taking office casual to a place you don’t want to go. On Monday you really don’t want to say, “Sue, I hadn’t realized you’d had a caesarian.” Or, “Melissa, no wonder you’re always smiling, Peter is hung like a horse.” If you go to this post-Thanksgiving hot tub party, it will make you hope for your own Hot Tub Time Machine, so that you can travel back in time and change your mind about having accepted the invitation. Lots of people let their belt out a notch at Thanksgiving, but thank goodness it’s not tradition for people to drop their drawers. You don’t want to start a new tradition of soaking with your co-worker and realizing your toe has wandered into someone’s nether regions. Just wish your would-be hostess a happy holiday and say family obligations call.

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“Attack of the Baby Snatcher: In a live chat, Prudie counsels a woman whose childless friend is obsessed with her infant daughter.”
“Drill Sergeant: In a live chat, Prudie counsels a man whose girlfriend shouts odd encouragements during sex.”